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Updated: Jul 31, 2025

Optimization of Transesophageal Atrial Pacing to Assess Atrial Fibrillation Susceptibility in Mice
Published on: June 29, 2022
Optimization of the atrioventricular delay in conduction system pacing.
Giovanni Coluccia1, Gabriele Dell'Era2, Chiara Ghiglieno2
1Cardiology Unit, "Card. G. Panico" Hospital, Tricase, Italy.
An electrophysiology-guided method effectively programs sensed atrioventricular delay (sAVD) in conduction system pacing (CSP) patients. This method, using His-bundle or left bundle branch pacing, achieved over 70% concordance with echocardiogram optimization.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Programming sensed atrioventricular delay (sAVD) in conduction system pacing (CSP) remains challenging.
- Optimal sAVD programming varies based on His-bundle (HB) or left bundle branch (LBB) capture type.
Purpose of the Study:
- To evaluate an electrophysiology (EP)-guided method for sAVD optimization.
- To compare EP-guided sAVD optimization with echocardiogram-guided optimization in CSP patients.
Main Methods:
- Patients undergoing HB or LBB pacing were enrolled.
- EP-guided sAVD was determined by achieving a 150 ms PR interval on ECG using local electrogram intervals.
- Echocardiogram-guided sAVD was identified using transmitral flow assessment via pulsed wave Doppler.
Main Results:
- Seventy-one patients were included: 12 selective HB, 32 nonselective HB, and 27 LBB capture.
- The overall concordance rate between EP-guided and echo-optimized sAVD was 71.8%.
- No significant differences in concordance were observed across the different capture types.
Conclusions:
- An optimal sAVD can be programmed in over 70% of CSP patients.
- Simple electrogram intervals can guide sAVD programming to achieve a physiological PR interval on surface ECG.
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